NPIMap

Individual provider Active NPI

Mina Tabibi, PA-C

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1386836609
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002594 Issued in VA
Practice address
1250 E Marshall St
Richmond, VA 23298-5051
Phone
(804) 828-0996
Fax
(804) 628-0384
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002594 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Richmond, VA 23298-5051

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Other practice location 1

7101 Jahnke Rd
Richmond, VA 23225-4017
Phone (804) 483-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071126000455 VA Practitioner - Physician Assistant 3779671888 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002594VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC CurrentSince Jun 1, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 1, 2021 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 1, 2021 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Jun 1, 2021 Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients

Locations

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1386836609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-0996",
            "fax_number": "804-628-0384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7101 Jahnke Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232254017",
            "country_code": "US",
            "telephone_number": "804-483-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABIBI",
        "first_name": "MINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.